Prepare a list of all campers with the following information complete for each camper. By listing each camper with signatures, they are agreeing to "hereby bind myself to the Camp Cazadero Medical Authorization and Release".
Information needed for each camper to be submitted upon arrival:
Please read medical authorization and release.
I/We, the undersigned do hereby authorize Cazadero Baptist Camp (the “Camp”), as agents for the undersigned, to consent to any X-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and it is to be rendered under the general or special supervision of any physician or other licensed health care provider. It is understood that this authorization is given in advance of any specific consent of any and all such diagnosis, treatment or hospital care, which the physician or other licensed health care provider, in the exercise of his or her best judgment may deem advisable. I/We understand that all costs related to medical treatment shall be my/our responsibility and not the Camp’s.
Further, authorization and permission is hereby given to the Camp to furnish any necessary transportation, food and lodging for this participant, at my/our sole expense and responsibility.
IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE CAMP PREMISES, FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION, USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY WAY, THE PARTICIPANT HEREBY AGREES TO THE FOLLOWING:
1. THAT THE PARTICIPANT HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the Camp, its directors, employees, and agents (hereinafter referred to as “releasees”) from all liability to the undersigned, his or her personal representatives, assigns, heirs and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person, up to an including death, the undersigned, his or her child or other person under his or her care, whether caused by the negligence of the releasees or whether while the undersigned is in, upon or about the Camp premises or any facilities or equipment therein.
2. THE PARTICIPANT HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned, his or her child or other person under his or her care, and upon or about the Camp premises or in any way observing or using any facilities or equipment of the Camp, whether caused by the negligence of the releasees or otherwise.
3. THE PARTICIPANT HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to the negligence of releasees or otherwise while in, about or upon the premises of the Camp and/or while using the premises or any facilities or equipment thereon.
4. THE PARTICIPANT further respectfully agrees that the foregoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall notwithstanding, continue in full legal force and effect.